Advances in 4D radiation therapy for managing respiration: Part I - 4D imaging

Geoffrey D. Hugo, Mihaela Rosu

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Techniques for managing respiration during imaging and planning of radiation therapy are reviewed, concentrating on free-breathing (4D) approaches. First, we focus on detailing the historical development and basic operational principles of currently-available "first generation" 4D imaging modalities: 4D computed tomography, 4D cone beam computed tomography, 4D magnetic resonance imaging, and 4D positron emission tomography. Features and limitations of these first generation systems are described, including necessity of breathing surrogates for 4D image reconstruction, assumptions made in acquisition and reconstruction about the breathing pattern, and commonly-observed artifacts. Both established and developmental methods to deal with these limitations are detailed. Finally, strategies to construct 4D targets and images and, alternatively, to compress 4D information into static targets and images for radiation therapy planning are described.

Original languageEnglish
Pages (from-to)258-271
Number of pages14
JournalZeitschrift fur Medizinische Physik
Issue number4
StatePublished - Dec 2012


  • 4D
  • Imaging
  • Radiation therapy
  • Respiration management
  • Treatment planning


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